liver Flashcards
hemolytic anemia is a common cause of
excess production of bilirubin
unconjugated bilirubin (indirect)
hydrophobic and nonpolar, bound do albumin
how is bilirubin conjugated?
by hepatocytes changing it to glucouronic acid
conjugated bilirubin is ____
hydrophilic and secreted into bile
final metabolism of bilirubin
by bacteria in the gut, converting to urobilinogen then stercobilin, then eliminated in feces.
what is first pass effect?
Liver metabolizes some of the drug before it exits through the hepatic vein.
Percent of cardiac output liver receives
20-25%
TRUE OR FALSE: Portal vein blood is oxygenated
FALSE - it is deoxygenated
The most specific marker for liver damage
ALT - because it is more specific to the liver
why do liver enzymes return to normal in End stage liver disease
fewer hepatocytes are dying.
most common cause of acute liver injury
drug-induced liver injury
activated by liver metabolism
prodrug
protein synthesis markers
albumin, PT (reflects production of coagulation proteins)
Elevates with liver failure
uptake and biotransformation capacity tests
bilirubin, indirect and direct
Tests for fibrosis of liver
ultrasound, MRI, CT, elastography, biopsy
antidote to tylenol overdose
N-acetylcysteine (replenishes glutathione
Required to detoxify acetaminophen metabolite NAPQI
glutathione
toxic metabolite in acetaminophen
N-acyetyl-p-benzoquinone-imine (NAPQI)
common findings in acute cholestasis
jaundice
hyperbilirubinemia
Blockage of bile flow
cholestasis
Most common cause of drug-induced cholestasis
antibiotics
findings of acute cholestasis
elevated GGT, ALP, 5” nucleotidase
increase in circulating bile salts
pruritis due to increased bile salts
pale stools, dark urine due to failure of bile secretion
causes of cholestasis
gallstones, neoplasms, pancreatic inflammation, reactions to drugs, pregnancy
hepatitis A route of infection
fecal-oral
diagnosis for hepatitis A
IgM, IgG titers to hep A antigens
